ABSTRACT This report described temporary hyperpigmentation occurring in a cat after use of the FreeStyle® Libre sensor by applying three different adhesive glues. The device was continuously used as an aid for the treatment of diabetes mellitus. Histopathological examination revealed mild focal chronic active dermatitis. While the coat color change occurred due to inflammation and did not affect the device functioning, owners should be alerted to the possibility of this complication.

RESUMO Este relato de caso descreveu a hiperpigmentação temporária que ocorreu em um gato após o uso do sensor FreeStyle® Libre, no qual foram aplicadas três colas adesivas diferentes. O dispositivo foi usado continuamente como auxiliar no tratamento do diabetes mellitus. O exame histopatológico revelou dermatite crônica ativa focal leve. Embora a mudança de cor da pelagem tenha ocorrido devido à inflamação e não tenha afetado o funcionamento do dispositivo, os proprietários devem ser alertados para a possibilidade dessa complicação.

RESUMO Objetivou-se, com este estudo, conhecer a percepção dos médicos veterinários quanto à monitorização da glicose sanguínea e intersticial em gatos com diabetes mellitus (DM) e/ou cetoacidose diabética, com ênfase no sistema flash de monitoramento da glicose (SFMG) (FreeStyle Libre, Abbott, Brasil). Esta pesquisa foi composta por duas etapas. Ao todo, foram obtidos 516 formulários de resposta. Desses, 480 (93%) foram considerados válidos. No total, 333 (69,4%) veterinários não utilizavam o SFMG, enquanto 147 (30,6%) o utilizavam. O custo do SFMG (116, 78%) foi a maior barreira para a aceitabilidade. Os médicos veterinários que utilizam o dispositivo consideram-no indispensável no monitoramento hospitalar da cetoacidose diabética por ser um facilitador no acompanhamento preciso das aferições. Além disso, o local de preferência para aplicação do sensor é na parede lateral cranial do tórax e é bem tolerável. Monitorar um felino diabético requer comprometimento do tutor e da equipe veterinária e que assegure um manejo amigo do gato.

ABSTRACT This study aimed to understand the perception of veterinarians regarding monitoring blood and interstitial glucose levels in cats with diabetes mellitus and/or diabetic ketoacidosis, with emphasis on the flash glucose monitoring system (FGMS) (FreeStyle Libre, Abbott, Brazil). This research consisted of two stages. In all, 516 response forms were obtained, and of these, 480 (93%) were considered valid. In total, 333 (69.4%) veterinarians did not use the FGMS, while 147 (30.6%) did. The cost of the FGMS (116, 78%) was the greatest deterrent to acceptability. Veterinarians who use the device consider it indispensable in the hospital monitoring of diabetic ketoacidosis and a facilitator in the accurate monitoring of measurements. In addition, the preferred location for application of the sensor is the cranial lateral wall of the chest and it is quite tolerable. Monitoring a diabetic cat requires commitment from the owner and the veterinary team to ensure feline-friendly management.

Resumen El artículo aborda la oposición teórica de dos modelos espaciales similares, pero conceptualmente diferentes, de cooperación transfronteriza en red (a saber, la integración territorial de las EMN y la integración informal de la red) desde el aspecto de la asimetría de poder corporativo de las empresas que participan en tales estructuras de red. Se presentan dos fenómenos externos de asimetría (simetría) de poder dando como ejemplo los casos de incrustación territorial e integración informal de redes en las regiones de América del Norte y Asia Oriental. El estudio presenta varias características que permiten proponer la atribución de sistemas de producción transfronterizos específicos a diferentes tipos de estructuras de red. Esto último se hace mediante una consideración de las características de la red, los efectos de la red y los detalles de la interacción del núcleo y la periferia de la red.

Abstract This article deals with a theoretical opposition of two similar, but conceptually different spatial models of transborder network cooperation (namely MNEs’ territorial embeddedness and informal network integration) from the aspect of corporate power asymmetry of firms participating in such network structures. Two external phenomena of power asymmetry (symmetry) are presented giving as example cases of territorial embeddedness and informal network integration in North America and East Asia regions. The study is resulted in several features allowing the attribution of specific transborder production systems to be proposed to different types of network structures. The latter is done by a consideration of network characteristics, network effects and specifics of network core and periphery interaction.

ABSTRACT Risk prevention approaches on activities, functions or processes are fundamental elements to prevent events that are harmful to companies. Each non-conforming product is related to undesirable events associated with the factors intervened in the process. The identification, analysis, evaluation, treatment, communication and monitoring of these unwanted events will help to increase the quality of the products and productivity in the production process. In this paper, we proposed a methodological design for the prevention of risks in production processes. The methodology proposes a novel way of combining statistical quality tools and the ISO 31000 standard for risk management. The validation was performed on a process of packaging of dairy products. The conclusions of this research show that the proposed methodological design is sufficiently flexible to be adapted to any type of manufacturing process that is desired to be monitored and improved.

RESUMEN Los enfoques de prevención de riesgos en actividades, funciones o procesos se han convertido en piezas fundamentales a la hora de minimizar la ocurrencia de eventos que son perjudiciales para las compañías. Cada producto no conforme está estrechamente ligado con eventos no deseados relacionados con uno o algunos de los factores que intervienen en el proceso. La identificación, análisis, evaluación, tratamiento, comunicación y monitoreo de estos eventos no deseados garantizarán el incremento de la calidad en los productos y la productividad en el proceso productivo. En este artículo, proponemos un diseño metodológico para la prevención de riesgos en procesos productivos. La metodología propone una forma novedosa de combinar el uso de herramientas estadísticas de calidad y la norma ISO 31000 de gestión de riesgos. La validación fue hecha sobre un proceso de envasado de productos lácteos. Las conclusiones de esta investigación muestran que el diseño metodológico propuesto es suficientemente flexible para ser adaptado a cualquier tipo de proceso de fabricación que se desea monitorear y mejorar.

The mining industry in the Democratic Republic of Congo has seen a significant expansion in copper and cobalt production in recent years. The greater proportion of this expansion has arisen through processing of oxide ores. The design of metallurgical processes for these oxide ores is based on the conventional equipment and layout for processing of sulphide ores, and comprises milling followed by leaching, solvent extraction, and electrowinning. The physical characteristics of the oxide ores, however, provide the process design engineer with an opportunity to examine critically the principles on which equipment selection is based and to design processes better suited to these ores. In 2015, ERG Africa began a project to expand the leaching capacity of the Luita hydrometallurgical facility. A number of innovative changes to the conventional process design were included in the modified flow sheet, which were validated when the project reached design throughput in November 2017. Of these changes, the most novel presented an alternative approach to mitigate the impact of colloidal silica on the operation of the solvent extraction plant.

This article questions whether a further gift of the Holy Spirit in Acts is the reversal of the curse of Babel and thus the rationale for multicultural local churches in an intercultural and globalised world. Using a non-empirical research design, including a literary survey of the Old Testament and New Testament texts and commentaries, the authors examine the significance of the division of language by God at Babel in the Genesis record. The inherent creational imago Dei, genetic and Noahic unity of all humans makes reconciliation, relationship and intercultural communication possible. This is followed by an examination of the impact of Pentecost, where the Holy Spirit's gift of tongues is found to symbolise the unifying of divided languages and cultures. This leads to the conclusion that the primary purpose of the gift of tongues was not centred on the controversial debate around glossolalia but rather on personal spiritual transformation and intercultural transformation. The Trinitarian nature of God enables all humans, made in his image, to once again be one in Christ. The centripetal gathering of all people at Babel, which led God to centrifugally scatter nations through language, was reversed in Acts 2 by God. This empowered the early church to go out centrifugally to all cultures. The conclusion is drawn that Acts 2 reverses the communication breakdown of Genesis 11 and, in this way, becomes the theological underpinning of multilingual and multicultural churches. Multicultural churches are thus not simply because of the prevailing winds of globalism in our day. INTRADISCIPLINARY AND/OR INTERDISCIPLINARY IMPLICATIONS: Acts 2 reversing Genesis 11 impacts the discipline of Ecclesiology from a missional perspective (multilingual and multicultural churches, heterogeneous local churches). The article deals broadly with Pneumatology and the Pneumatological rationale, as well as intercultural studies, intercultural communication, intercultural pastoral care, conflict resolution and globalism. Heterogeneous local churches call for a change in the discourse (which is both possible and necessary in a globalised world) of the traditional homogenous church growth principle. This article has broad overlap with some social science theory related to communication, culture and anthropology and offers interesting biblical-cultural insights probing the biblical text.

Background: High-sensitivity cardiac troponin (hs-cTn) T and I assays are established as crucial tools for the diagnosis of acute myocardial infarction (AMI), as they have been found superior to old troponin assays. However, eventual differences between the assays in prediction of significant coronary lesions and long-term prognosis in patients with acute coronary syndrome (ACS) have not been fully unraveled. Methods: Serum concentrations of hs-cTnT (Roche), hs-cTnI (Abbott), and amino-terminal pro-B-type natriuretic peptide (NT-proBNP; Roche) in 390 non-ST-elevation (NSTE) ACS patients were evaluated in relation to significant coronary lesions on coronary angiography (defined as a stenosis >50% of the luminal diameter, with need for revascularization) and prognostic accuracy for cardiovascular mortality, all-cause mortality, as well as the composite end point of cardiovascular mortality and hospitalizations for AMI or heart failure. Results: The mean+SD follow-up was 2921+168 days. Absolute hs-cTnI concentrations were significantly higher than the hs-cTnT concentrations. The relationship between analyzed biomarkers and significant coronary lesions on coronary angiography, as quantified by the area under the ROC curve (AUC), revealed no difference between hs-cTnT [AUC, 0.81; 95% CI, 0.77-0.86] and hs-cTnI (AUC, 0.81; 95% CI, 0.76-0.86; P=NS). NT-proBNP was superior to both hs-cTn assays regarding prognostic accuracy for both cardiovascular and all-cause mortality and for the composite end point during follow-up, also in multivariate analyses. Conclusions: The hs-cTnT and hs-cTnI assays displayed a similar ability to predict significant coronary lesions in NSTE-ACS patients. NT-proBNP was superior to both hs-cTn assays as a marker of long-term prognosis in this patient group.

Antecedentes: Los ensayos de troponinas cardíacas de alta sensibilidad (hs-cTn) tanto T e I son una herramienta crucial y bien establecida para el diagnóstico de infarto agudo de miocardio (IAM), ya que se ha demostrado ampliamente su superioridad respecto a las antiguas determinaciones de troponina. Sin embargo, eventuales diferencias entre ambos ensayos en la predicción de lesiones coronarias significativas y el pronóstico a largo plazo en pacientes con síndrome coronario agudo (SCA) no han sido aclarados completamente. Métodos: Se evaluaron las concentraciones séricas de hs-cTnT (Roche), hs-cTnI (Abbott) y porción amino-terminal del pro-péptido natriurético tipo B (NT-proBNP) (Roche) en 390 pacientes con SCA sin elevación del segmento ST, y se relacionaron con lesiones coronarias significativas detectadas por angiografía coronaria (definidas como estenosis >50% del diámetro luminal, con necesidad de revascularización) y con la precisión pronóstica de mortalidad cardiovascular, mortalidad por cualquier causa, así como también con el punto final compuesto por mortalidad cardiovascular y hospitalizaciones por IAM o insuficiencia cardiaca. Resultados: La media (+DE) del seguimiento fue de 2921+168 días. Las concentraciones absolutas de hs-cTnI fueron significativamente mayores que las concentraciones de hs-cTnT. La relación entre los biomarcadores analizados y lesiones coronarias significativas en angiografía coronaria, cuantificada por el área bajo la curva ROC (AUC), no reveló diferencias entre hs-cTnT [AUC, 0,81; IC del 95%, 0,77- 0,86] y hs-cTnI (AUC, 0,81; IC del 95%, 0,76-0,86; P=NS). Sin embargo, NT-proBNP fue superior a ambos ensayos de hs-cTn en relación con la precisión pronóstica tanto para mortalidad cardiovascular y por cualquier causa, como para el punto final compuesto durante el seguimiento, aún también en análisis multivariados. Conclusiones: Los determinaciones de hs-cTnT y hs-cTnI mostraron una capacidad similar para predecir lesiones coronarias significativas en pacientes con SCA sin elevación del segmento ST. NT-proBNP fue superior a ambos ensayos de uscTn, como marcador de pronóstico a largo plazo en este grupo de pacientes.

La presente investigación propone un proceso de mejora continua en el que se combinan herramientas estadísticas de calidad, como los gráficos de control, el diagrama de Pareto y el diagrama causa-efecto y el proceso de gestión de riesgo contenido en la Norma Técnica Colombiana-NTC 5254 e ISO 31000, con el objetivo de reducir los defectos que se puedan presentan en un sistema productivo de transformación. La propuesta busca ser una guía para combinar herramientas de calidad y normas de gestión teniendo en cuenta siempre las condiciones de operación de la compañía. El proceso de mejora propuesto inicia con la identificación de los productos y operaciones que representa un eslabón crítico para la organización dentro de su línea de producción y culmina con la revisión y monitoreo de las acciones propuesta para mitigar las fuentes de no conformidades identificadas. Se muestra la forma de implementar eficazmente el proceso de gestión de riesgos en sistemas productivos y de manufactura

This paper proposes a process of continuous improvement in which some statistical tools of quality (Control charts, the Pareto diagram and the cause-effect diagram) and risk management process contained in the NTC 5254 and ISO 31000 are used. The objective is to propose a set of simple steps to reduce the defects that occur in a production system. The proposal seeks to be a guide for combining quality tools and management standards while taking into account the operating characteristics of the company. The proposed improvement process starts with the identification of products and processes critical to the organization within its product line and ends with review and monitoring of the actions proposed to mitigate the sources of nonconformities identified. It seeks to show how to implement a process of risk management in production systems and manufacturing

Between September 1998 and February 2003, 204 children underwent cardiac surgery in Trinidad and Tobago to correct or palliate congenital heart disease. The defects included isolated ventricular or atrial septal defects as well as tetralogy of fallot and coarctation of the aorta. A few patients also had complex cyanotic congenital heart disease. The patients ranged in age from 2 days to 17 years. In some cases, palliative surgery was undertaken as a first step towards complete correction but the majority of patients underwent complete repair. The commonest postoperative complications were haemorrhage and small transient pericardial effusions. The overall mortality rate was < 1%. This paper describes the cardiac lesions, post-operative morbidity and mortality of these patients.

Entre septiembre de 1998 y febrero de 2003, 204 niños fueron sometidos a cirugía cardíaca en Trinidad y Tobago, a fin de corregir o paliar la enfermedad cardíaca congénita. Las cardiopatías incluían defectos septales atriales o venticulares aislados, así como tetralogía de Fallot y coartación de la aorta. Algunos pacientes también presentaban cardiopatía congénita cianótica compleja. Los pacientes tenían edades que fluctuaban de dos días a 17 años. En algunos casos, la cirugía paliativa se emprendió como un primer paso hacia la corrección completa pero a la mayoría de los pacientes se les practicó la reparación completa. Las complicaciones más comunes del post-operatorio fueron hemorragias y pequeñas efusiones pericadiales transitorias. La tasa general de mortalidad fue <1%. Este trabajo describe las lesiones cardíacas, la morbilidad y mortalidad post-operatoria de estos pacientes.